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The World Bank, under the stewardship of the United States, stands out as the global leader among international development organizations. Does China's establishment of the Asian Infrastructure Investment Bank (AIIB) undermine this status? Examining this question, we focus on the borrowing practices of a special set of countries: the founding members of the AIIB. These founders openly defied the public preference of the United States, arguably to create a potential rival to the World Bank. Using a new causal inference method, Pang, Liu, and Xu's Dynamic Multilevel Latent Factor Model—as well as several well-known estimation models as robustness checks—we document at least a temporary decrease in the number of World Bank infrastructure projects that the developing AIIB founders have entered into. This study presents the first systematic evidence that China's AIIB could unsettle the political influence the United States has enjoyed over developing countries through its leadership of the World Bank. An important set of countries may be parting ways with the World Bank and looking to a Chinese institution for leadership in the world of development.
Previous research has shown that using foreign languages reduces cognitive biases. Here, we investigate whether this foreign-language effect extends to self-related cognition – in particular, the self-positivity bias, which refers to automatic association of oneself with positive information and has a facilitation role in maintaining mental health. We applied event-related brain potentials and oscillations in the implicit association test where Chinese–English bilinguals responded to category words (self vs. others) and attribute words (positive vs. negative) in either their native language Chinese or their foreign language English. In response to Chinese words, a self-positivity bias occurred, indexed by a positive D-score in reaction times as well as by smaller N200, larger P3-like/LPC responses, and lower alpha desynchronization when self words were associated with positive relative to negative traits. However, the bias was diminished in the English context. Overall, our findings provide important implications for language choices when self-protective mechanisms should be enhanced.
Hormone-sensitive lipase (HSL) is one of the rate-determining enzymes in the hydrolysis of TAG, playing a crucial role in lipid metabolism. However, the role of HSL-mediated lipolysis in systemic nutrient homoeostasis has not been intensively understood. Therefore, we used CRISPR/Cas9 technique and Hsl inhibitor (HSL-IN-1) to establish hsla-deficient (hsla-/-) and Hsl-inhibited zebrafish models, respectively. As a result, the hsla-/- zebrafish showed retarded growth and reduced oxygen consumption rate, accompanied with higher mRNA expression of the genes related to inflammation and apoptosis in liver and muscle. Furthermore, hsla-/- and HSL-IN-1-treated zebrafish both exhibited severe fat deposition, whereas their expressions of the genes related to lipolysis and fatty acid oxidation were markedly reduced. The TLC results also showed that the dysfunction of Hsl changed the whole-body lipid profile, including increasing the content of TG and decreasing the proportion of phospholipids. In addition, the systemic metabolic pattern was remodelled in hsla-/- and HSL-IN-1-treated zebrafish. The dysfunction of Hsl lowered the glycogen content in liver and muscle and enhanced the utilisation of glucose plus the expressions of glucose transporter and glycolysis genes. Besides, the whole-body protein content had significantly decreased in the hsla-/- and HSL-IN-1-treated zebrafish, accompanied with the lower activation of the mTOR pathway and enhanced protein and amino acid catabolism. Taken together, Hsl plays an essential role in energy homoeostasis, and its dysfunction would cause the disturbance of lipid catabolism but enhanced breakdown of glycogen and protein for energy compensation.
The hydrodynamic mechanism of drag reduction by a flexible hairy coating was explored using the penalty immersed boundary method. A two-dimensional flexible hairy coating is constituted by multiple flexible filaments. A simulation of a cylinder without a hairy coating at a Reynolds number of 100 was also performed for comparison. The results of the simulations show good agreement with the experimental data by Niu & Hu (Phys. Fluids, vol. 23, 2011, 101701), where maximum drag reduction of 22% was attained at a particular length, bending rigidity, coating density and coating angle of the hairy coating. The hydrodynamic mechanism of drag reduction was characterized in terms of the wake pattern, shape deformation and kinetic energy of the hairy coating. The effect of a non-uniform bending rigidity of the hairy coating on drag reduction was explored. A stable streamline shape of the hairy coating was found to delay the vortex formation and stabilize the recirculation zone, resulting in decreased form drag. Active flapping of the hairy coating with enhanced vortex shedding is adverse to drag reduction. A hairy coating with a stiff base and flexible trailing edge is beneficial to maintaining a stable shape.
We examine the relationship between high-performance work system (HPWS) and job satisfaction, drawing on the ‘too much of a good thing’ theory, to establish whether a non-linear relationship can explain conflicts in previous findings. Moreover, we extend the study by exploring the mediating role of work overload and the moderating role of person–organization fit (P–O fit). Based on a cross-sectional data set of 220 employees and a longitudinal data set of 373 employees from organizations in China, the empirical findings show an inverted U-shaped relationship between HPWS and job satisfaction. Results also indicate that the relationship between HPWS and job satisfaction is fully mediated by work overload, and that P–O fit negatively moderates HPWS-work overload and HPWS-job satisfaction relationships. These results shed new light on how HPWS impacts employee outcomes and practical implications for managers are discussed.
Hyperhomocysteinaemia (HHcy) is associated with all-cause mortality in some disease states. However, the correlation between HHcy and the risk of mortality in the general population has rarely been researched. We aimed to evaluate the association between HHcy and all-cause and cause-specific mortality among adults in the USA. This study analysed data from the National Health and Nutrition Examination Survey database (1999–2002 survey cycle). A multivariable Cox regression model was built to evaluate the correlation between HHcy and all-cause and cause-specific mortality. Smooth curve fitting was used to analyse their dose-dependent relationship. A total of 8442 adults aged 18–70 years were included in this study. After a median follow-up period of 14·7 years, 1007 (11·9 %) deaths occurred including 197 CVD-related deaths, 255 cancer-related deaths and fifty-eight respiratory disease deaths. The participants with HHcy had a 93 % increased risk of all-cause mortality (hazard ratio (HR) 1·93; 95 % CI (1·48, 2·51)), 160 % increased risk of CVD mortality (HR 2·60; 95 % CI (1·52, 4·45)) and 82 % increased risk of cancer mortality (HR 1·82; 95 % CI (1·03, 3·21)) compared with those without HHcy. For unmeasured confounding, E-value analysis proved to be robust. In conclusion, HHcy was associated with high risk of all-cause and cause-specific (CVD, cancer) mortality among adults aged below 70 years.
We have grown intermetallic ErPd2Si2 single crystals employing laser diodes with the floating-zone method. The temperature dependence of the unit-cell parameters was determined using synchrotron and in-house X-ray powder diffraction measurements from 20 to 500 K. The diffraction patterns fit well with the tetragonal I4/mmm space group (No. 139) with two chemical formulae within the unit cell. The synchrotron powder diffraction study shows that the refined unit-cell parameters are a = 4.10320(2) Å, c = 9.88393(5) Å at 298 K and a = 4.11737(2) Å, c = 9.88143(5) Å at 500 K, resulting in the unit-cell volume V = 166.408(1) Å3 (298 K) and 167.517(2) Å3 (500 K). In the whole studied temperature range, no structural phase transition was observed. Upon cooling, the unit-cell parameters a and c are shortened and elongated, respectively.
Vitamin D is engaged in various neural processes, with low vitamin D linked to depression and cognitive dysfunction. There are gender differences in depression and vitamin D level. However, the relationship between depression, gender, vitamin D, cognition, and brain function has yet to be determined.
Methods
One hundred and twenty-two patients with major depressive disorder (MDD) and 119 healthy controls underwent resting-state functional MRI and fractional amplitude of low-frequency fluctuations (fALFF) was calculated to assess brain function. Serum concentration of vitamin D (SCVD) and cognition (i.e. prospective memory and sustained attention) were also measured.
Results
We found a significant group-by-gender interaction effect on SCVD whereby MDD patients showed a reduction in SCVD relative to controls in females but not males. Concurrently, there was a female-specific association of SCVD with cognition and MDD-related fALFF alterations in widespread brain regions. Remarkably, MDD- and SCVD-related fALFF changes mediated the relation between SCVD and cognition in females.
Conclusion
Apart from providing insights into the neural mechanisms by which low vitamin D contributes to cognitive impairment in MDD in a gender-dependent manner, these findings might have clinical implications for assignment of female patients with MDD and cognitive dysfunction to adjuvant vitamin D supplementation therapy, which may ultimately advance a precision approach to personalized antidepressant choice.
Natural enemies that impact pest populations must be understood in order to build integrated pest control strategies and to understand the most important aspects affecting pest dynamics. Haloxylon ammodendron (C. A. Mey.) Bunge is an important perennial plant species extensively used in sand stabilization and wind prevention in arid areas. This study aimed to determine the main defoliators that damage H. ammodendron and the parasitoid complex associated with them. Twelve species of defoliators were found in Northern Xinjiang, and Teia dubia (Tauscher) (Lepidoptera: Lymantriidae), Scrobipalpa sp. (Lepidoptera: Gelechiidae), and Eucharia festiva Hüfnagel (Lepidoptera: Arctiidae) were the dominant pests. T. dubia is the predominant defoliator with three generations a year. Northwest China, Central Asia, and the Mediterranean region are potentially suitable habitats for T. dubia in the world, while Xinjiang is the primary distribution area in China. Parasitoids belonging to seven species and four families were reared from the larvae of T. dubia, they were all endoparasitoids and koinobiont. Cotesia sp. (Hymenoptera: Braconidae) is the dominant parasitoid and prefer to parasitic in the 3rd–5th instar larvae. The present study provides the basis for understanding the species composition and natural enemies of lepidopteran defoliators. It will be an effective tool for the integrated pest management programs of H. ammodendron forest.
Social cognition has not previously been assessed in treatment-naive patients with chronic schizophrenia, in patients over 60 years of age, or in patients with less than 5 years of schooling.
Methods
We revised a commonly used measure of social cognition, the Reading the Mind in the Eyes Test (RMET), by expanding the instructions, using both self-completion and interviewer-completion versions (for illiterate respondents), and classifying each test administration as ‘successfully completed’ or ‘incomplete’. The revised instrument (RMET-CV-R) was administered to 233 treatment-naive patients with chronic schizophrenia (UT), 154 treated controls with chronic schizophrenia (TC), and 259 healthy controls (HC) from rural communities in China.
Results
In bivariate and multivariate analyses, successful completion rates and RMET-CV-R scores (percent correct judgments about emotion exhibited in 70 presented slides) were highest in HC, intermediate in TC, and lowest in UT (adjusted completion rates, 97.0, 72.4, and 49.9%, respectively; adjusted RMET-CV-R scores, 45.4, 38.5, and 34.6%, respectively; all p < 0.02). Stratified analyses by the method of administration (self-completed v. interviewer-completed) and by education and age (‘educated-younger’ v. ‘undereducated-older’) show the same relationship between groups (i.e. NC>TC>UT), though not all differences remain statistically significant.
Conclusions
We find poorer social cognition in treatment-naive than in treated patients with chronic schizophrenia. The discriminant validity of RMET-CV-R in undereducated, older patients demonstrates the feasibility of administering revised versions of RMET to patients who may otherwise be considered ineligible due to education or age by changing the method of test administration and carefully assessing respondents' ability to complete the task successfully.
The scientific application of clinical evidence-based guidelines can reduce the variability of clinical practice, and standardize clinical diagnosis and treatment pathways. At present, many evidence-based guidelines on Chronic Obstructive Pulmonary Disease (COPD) prevention have been issued in countries around the world, but the procedures and evaluation strategies developed by different guidelines are not the same. This study aimed to evaluate the quality of published clinical practice guidelines (CPGs) relating to COPD using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument.
Methods
Databases were systematically searched PubMed, EMBASE, Wan Fang, and CNKI as well as guidelines websites on COPD prevention and treatment. The search period was from inception of the database up to May 2019. The inclusion criteria for this study are as follows: (i) published and in accordance with the definition of the practice guidelines; (ii)the main target population is COPD patients with the diagnostic criteria of the 2019 edition of the global initiative for COPD (GOLD), and the content of the guideline is related to the prevention and treatment practice of COPD; (ii) the same guide is included in the latest updated version; (iv) the published language is English or Chinese. Guidelines that met these inclusion criteria were evaluated for the quality of the AGREE II guidelines. Then, a descriptive analysis was made of the consensus that exists in the guidelines.
Results
A total of fifteen guidelines/Consensuses Statements were included in the study. Two guidelines were assessed as recommended, eleven guidelines were assessed as recommended with modifications and two guidelines were not recommended. The mean scores of the included guidelines in the six domains (scope and purpose, personnel involved in guideline development, rigor of development, clarity, applicability, independence) were 90 percent, 72 percent, 49 percent, 96 percent, 60 percent, 69 percent, respectively. Thus, the study identified a consensus that disease risk factors and recommended interventions were mentioned in the guidelines, and that they comprehensively evaluated the quality of guideline reporting to provide reference for standardizing the development of practice guidelines for COPD in China.
Conclusions
The overall methodological quality of COPD CPGs should be improved. The key recommended areas for improvement include standardization of guideline report writing and synthesis of the latest and best evidence, to develop CPGs for COPD to improve the quality of clinical diagnosis and treatment for COPD.
Ankylosing spondylitis (AS) is a common disease that causes pain and affects productivity. Tumor necrosis factor-α (TNF-α) like adalimumab can bring better clinical efficacy and improve quality of life. Adalimumab is likely to be covered by health insurance. It is necessary to assess the impact of adalimumab for patients with AS on the medical insurance budget in China. Our research aims to give support evidence for policy-making.
Methods
From the perspective of medical insurance payers, a budget impact model was established to evaluate the impact of adalimumab for the treatment of adults with severe active AS that has responded inadequately to conventional therapy. The time horizon was 5 years (2020–2024). The cost of measurement included drug and treatment costs for adverse events. Scenario analysis was conducted to evaluate the results under different drug price reimbursement ratios and treatment ratios.
Results
Based on the current price of adalimumab (CNY 3,160 [USD 446]/unit), under the reimbursement ratio of 70 percent, adalimumab will increase medical insurance expenditure by CNY 162 [USD 22] million, CNY 152 [USD 21] million, CNY 114 [USD 16] million, CNY 100 [USD 14] million and CNY 88.11 [USD 12] million in the next 1–5 years, respectively. The increased medical insurance expenditure accounts for 0.091, 0.085, 0.064, 0.056, and 0.049 percent of the annual medical insurance expenditure in the next 1–5 years, respectively, which is assumed to be equivalent to the expenditure in 2018 of CNY 1782.2 [USD 251] billion.
Conclusions
The budget impact of adalimumab for AS on medical insurance expenditure is limited, and including adalimumab in the medical insurance catalogue can reduce the burden on individuals, enrich treatment options, and satisfy clinical needs better.
Spinal muscular atrophy (SMA) is a rare, life-threatening, and seriously debilitating neuromuscular disorder, which has a heavy burden on patients, caregivers and the health system. Technological advances have improved clinical effect, but have also increased the financial burden. There is limited information in the literature on the resource utilization and economic burden of SMA. Our research aims to summarize the current literature on resource use, cost and economic evaluations of treatments for SMA, to inform further research and policy decision making.
Methods
Databases, including PubMed, Embase, Cochrane Library and CRD Database, were searched from inception. Two reviewers undertook title and abstract screening followed by full-text screening, and any disagreement was resolved in consensus. Data extraction was conducted using a customized form. Included studies were summarized using narrative synthesis structured around general and economic characteristics. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adhered to where applicable.
Results
We reviewed 552 abstracts and included twenty-six from 2015 to 2019. Four-fifths were published in the United States and Europe. Five full economic evaluations and one budget impact analysis compared nusinersen with AVXS-101 or best supportive care, and the remaining evaluated the economic burden of SMA. The most common outcomes were healthcare resource utilization and direct medical costs, only a few studies evaluated direct non-medical costs or indirect cost.
Conclusions
SMA patients have significant medical expenditures and high utilization of healthcare services, including nusinersen-treated patients. The results highlight the substantial burden of treatment for SMA, not only for patients but also for their caregivers. SMA represents a significant hidden cost that society should be made aware of, and that should be considered in the design, implementation and evaluation of support programs for people who suffer from this disease and their families, as well as in the economic evaluation of new treatments.
Chronic fatigue syndrome (CFS) is characterized by extreme fatigue and disabling symptoms. Women with CFS often have a high risk of gynaecological problems such as irregular menstruation, endometriosis and pelvic pain and sexual dysfunction. Our previous results have shown that, in pregnant mice, CFS significantly decreased the progestational hormone level in serum, as well as learning and memory, and the function of the hypothalamus–pituitary–gonadal axis. In addition, the F1 generation also suffered from congenital hypothyroidism. At present, there has been no report about placenta formation and embryonic development in pregnant mice with CFS. The aim of the present study was to investigate the influence of CFS on the morphology, oxidative stress and Wnt/β-catenin signalling pathway during placenta formation. In this study, we found that CFS decreased the number of implantation sites for blastocysts, and increased the number of absorbed, stillborn and malformed fetuses. The morphology and structure of the placenta were abnormal in pregnant mice with CFS. Further study found that the oxidative stress in serum, uterus and placenta was increased in pregnant mice with CFS, while the levels of antioxidase were decreased. CFS also inhibited the Wnt/β-catenin signalling pathway in the placenta. These results suggested that inhibition of the Wnt/β-catenin signalling pathway and enhanced oxidative stress play an important role in abnormal placentation in pregnant mice with CFS.
Boronic ester bonds can be reversibly formed between phenylboronic acid (PBA) and triol moieties. Here, we aim at a glucose-induced shape-memory effect by implementing such bonds as temporary netpoints, which are cleavable by glucose and by minimizing the volume change upon stimulation by a porous cryogel structure. The polymer system consisted of a semi-interpenetrating network (semi-IPN) architecture, in which the triol moieties were part of the permanent network and the PBA moieties were located in the linear polymer diffused into the semi-IPN. In an alkaline medium (pH = 10), the swelling ratio was approximately 35, independent of Cglu varied between 0 and 300 mg/dL. In bending experiments, shape fixity Rf ≈ 80% and shape recovery Rr ≈ 100% from five programming/recovery cycles could be determined. Rr was a function of Cglu in the range from 0 to 300 mg/dL, which accords with the fluctuation range of Cglu in human blood. In this way, the shape-memory hydrogels could play a role in future diabetes treatment options.
A suite of Jurassic–Cretaceous migmatites was newly identified in the Liaodong Peninsula of the eastern North China Craton (NCC). Anatexis is commonly associated with crustal thickening. However, the newly identified migmatites were formed during strong lithospheric thinning accompanied by voluminous magmatism and intense deformation. Field investigations show that the migmatites are spatially associated with low-angle detachment faults. Numerous leucosomes occur either as isolated lenses or thin layers (dykes), parallel to or cross-cutting the foliation. Peritectic minerals such as titanite and sillimanite are distributed mainly along the boundaries of reactant minerals or are accumulated along the foliation. Most zircons show distinct core–rim structures, and the rims have low Th/U ratios (0.01–0.24). Zircon U–Pb dating results indicate that the protoliths of the migmatites were either the Late Triassic (224–221 Ma) diorites or metasedimentary rocks deposited sometime after c. 1857 Ma. The zircon overgrowth rims record crystallization ages of 173–161 Ma and 125 Ma, which represent the formation time of leucosomes. These ages are consistent with those reported magmatic events in the Liaodong Peninsula and surrounding areas. The leucosomes indicate a strong anatectic event during the Jurassic–Cretaceous period. Partial melting occurred through the breakdown of muscovite and biotite with the presence of water-rich fluid under a thermal anomaly regime. The possible mechanism that caused the 173–161 Ma and 125 Ma anatectic events was intimately related to the regional crustal extension during the lithospheric thinning of the NCC. Meanwhile, the newly generated melts further weakened the rigidity of the crust and enhanced the extension.